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Article Type

Original Study

Abstract

Introduction Mitral valve repair in pediatrics has been slow because of the great variety in congenital mitral valve malformations and the still unknown growing effect over the mitral valve. The aim of this study is to evaluate the early and mid-term results in surgical repair of mitral valve regurgitation in pediatrics and children. Patients and methods A total of 16 patients had mitral valve repair for mitral regurgitation (MR) between November 2016 and December 2020 at the National Heart Institute. There were seven (43.75%) males and nine (56.25%) females. The mean age was 7.5 years (5 months and 14 years). The mean weight was 19.9 kg (5.5–40 kg). Concomitant procedures were done in 11 (68.75%) patients. The mean cardiopulmonary bypass time was 82 min (40–150 min), and the mean aortic cross-clamp time was 59 min (25–110 min). Results There was only one (6.25%) early mortality after 3 months. The number of patients who had posterior patch annuloplasty was six (37.5%), rigid rings was four (25%), whereas suture annuloplasty was five (31.25%). The mean postoperative mitral valve gradient was 5 mmHg (3.5–8 mmHg). More than 50% of patients with suture annuloplasty had moderate MR, whereas posterior patch annuloplasty had trivial to mild MR and rigid ring annuloplasty had trivial MR. Aortic valve surgery was done in two (12.5%) cases. The mean hospital stay was 7.2 days (4–14 days) and ICU mean stay was 2.9 days (1–7 days), with a mean mechanical ventilation time of 6 h (2–15 h). Reoperation was done in four (26.6%) patients, with 81.25% freedom from reoperation for mitral valve prosthetic replacement. Conclusion Mitral valve repair for mitral valve regurgitation in pediatrics and children improves symptoms, valve function, and myocardial performance and delays replacement. Posterior patch and ring annuloplasty have satisfactory early and mid-term results, low mortality, and a high freedom from reoperation.

Keywords

Mitral valve repair, posterior patch, ring, suture annuloplasty

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